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What is a spousal surcharge and a Spousal Medical Plan Affidavit?
The spousal surcharge of $250 per month is added for a spouse who has access to a medical plan through his or her employer yet is enrolled in the BPS Health Plan as the primary coverage. This surcharge will not apply if your spouse doesn’t work, works for an employer who does not offer
medical insurance, or if your spouse elects medical coverage through his or her employer but is also enrolled in medical coverage as a dependent under your plan. In the latter instance, your spouse’s plan will be utilized as primary coverage, and the BPS Health Plan will be utilized as secondary coverage.
When you link your spouse to medical coverage during open enrollment, you will be guided to the online spousal medical plan affidavit to complete. If you are adding your spouse midyear with a
qualifying event, then you MUST complete a paper affidavit, sign it, and return the original document to the Office of Employee Benefits.
Why do I have to complete an Over-Age Dependent Affidavit?
The State of Florida mandates that group plans allow parents to keep children between 26 and 30 years of age on their health plan as long as the child is not married, has no children, has no other medical coverage, lives in Florida or, if not a Florida resident, is a full- or part-time student.
When you link an over-age child to medical coverage during open enrollment, you will be guided to the online dependent affidavit to complete. If you are adding your child midyear with a qualifying event, then you MUST complete a paper affidavit, sign it, and return the original document to the Office of Employee Benefits.
How do I determine if a medical service will be covered by the BPS Health Plan?
It is YOUR responsibility to confirm if a service will be covered by the health plan. A provider’s office may or may not know the specifics of the BPS Health Plan. Whenever possible, you should contact Cigna’s customer service at 800-244-6224 BEFORE you receive medical services if there is any question about coverage.
How are laboratory services covered?
Covered in-network laboratory expenses at a physician’s office, independent lab, outpatient facility, and urgent care facility are paid at 100% by the plan. If lab work is performed at your physician’s office, you will only be charged the office visit copay for that visit. In an emergency room setting, the plan pays in-network laboratory expenses at 80% after you have met your deductible.
How can I find a lab or health care provider in the BPS health plan network?
You can check for a laboratory or healthcare provider by signing on to our plan administrator’s website http://www.cigna.com.
1. On the top left hand corner, click on “Individual & Family Plans”
2. Click on “Find Your Doctor”
From there you can search for a Doctor, Hospital, Pharmacy or Facility that is in the network
3. Enter your search location
4. Select a plan. The BPS Health Plan utilizes the Open Access Plus (OAP) network
5. Then choose the type of doctor, lab, pharmacy or facility you are searching for and hit the Search button
You can also call Cigna’s customer service number at 1-800-244-6224. 36 | BPS Employee Benefits Guide
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